Autonomic dysfunction is related to impaired pancreatic β cell function in patients with coronary artery disease. Issue 2 (1st February 2000)

• Record Type: Journal Article
• Authors: Sayer, J W; Marchant, B; Gelding, S V; Cooper, J A; Timmis, A D
• Is Part Of: Heart. Volume 83:Issue 2(2000)
• Page Start: 210
• Page End: 216
• Publication Date: 2000-02-01
• Subjects: ischaemic heart disease -- autonomic nervous system -- β cell function -- diabetes mellitus; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heart.83.2.210
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : OBJECTIVE: To assess the role of β cell failure in the development of autonomic dysfunction in patients with coronary artery disease. DESIGN: Autonomic function was measured by standard clinical methods and by heart rate variability in 24 type II diabetic and 24 non-diabetic subjects with coronary artery disease. Quantitative estimates of pancreatic β cell function (%β) and insulin resistance were made from basal plasma glucose and insulin concentrations using a computer solved model. Fasting proinsulin levels provided an independent measure of β cell function. RESULTS: The circadian rhythm of sympathovagal balance (ratio of low to high frequency spectral components of heart rate variability) was significantly attenuated in patients with below median (%β ⩽ 63.3) compared with above median pancreatic β cell function. Multiple measures of autonomic function showed positive associations with %β (low frequency: r = 0.41, p = 0.004; high frequency: r = 0.27, p = 0.07; lying/standing fall in systolic pressure: r = −0.30, p = 0.04) and negative associations with proinsulin (low frequency: r = −0.35, p = 0.03; high frequency: r = −0.36, p = 0.02; standard deviation of RR intervals: r = −0.43, p = 0.007). Associations tended to be stronger in non-diabetic than diabetic patients. In contrast, there was no association between insulin resistance and either autonomic function or the circadian rhythm of sympathovagal balance, regardless of diabetes status. CONCLUSIONS: The data are consistent with the hypothesis that β cell failure plays a pathogenic role in the development of autonomic dysfunction in patients with coronary artery disease.